Lumbar puncture is a procedure that, by the general, aims to collect a sample of cerebrospinal fluid that bathes the brain and the spinal cord, through the insertion of a needle between the vertebrae of the lumbar region until reaching the subarachnoid space, which it is a space between the layers that review the spinal cord through which the liquid passes.
This technique is used to identify neurological alterations that can be caused by an infection, such as the case of meningitis or encephalitis, or diseases such as multiple sclerosis or subarachnoid hemorrhage. In addition, it can also be used to inject drugs into the cerebrospinal fluid, such as chemotherapy or antibiotics.
The lumbar puncture has several indications, which include:
Laboratory analysis of cerebrospinal fluid to identify and evaluate diseases;
Measurement of cerebrospinal fluid pressure;
Injection of drugs such as antibiotics and chemotherapy;
Stadification or treatment of leukemias and lymphomas;
Injection of contrast or radioactive substances to perform radiographs.
The laboratory analysis is designed to detect disorders of the central nervous system, such as bacterial, viral or fungal infections such as meningitis, encephalitis or syphilis; In addition to identifying bleeding, cancer or diagnosing certain inflammatory or degenerative conditions of the nervous system such as multiple sclerosis, Alzheimer’s disease or Guillain-Barré syndrome.
Before the procedure, no special preparation is required unless there is a clotting problem or the use of a medication that interferes with the technique, such as anticoagulants.
The person can place himself in one of the positions, leaning on his side with the inflected wheels and the head next to the pecho, called fetal position or sitting with the head and the inflected column with adelante and the crossed arms.
Then, the doctor applies an antiseptic solution in the lumbar region and looks for the area between the L3 and L4 or L4 and L5 vertebrae, being able to inject an anesthetic medication in this place. Then, a fine needle is slowly introduced between the vertebrae until it reaches the subarachnoid space, from where the liquid flows and drips through the needle to be collected in a sterile test tube.
Finally, the needle is removed and a deposit is placed in the place of the puncture. This procedure lasts approximately a few minutes, without embargo, the doctor can obtain the sample of cerebrospinal fluid introduced in the needle, and it may be necessary to divert the direction of the needle or to perform the puncture again in another region.
This procedure is generally safe, with times of possibility of presenting complications or risks for the person. The most common secondary effect that can occur after a lumbar puncture is pain in the temporal head due to the decrease in cerebrospinal fluid in the surrounding tissues, and nausea and vomiting can also occur if the person falls ashore after the exam
There may also be pain and discomfort in the lumbar region, which can be relieved with painkillers recommended by the doctor and sometimes infection or bleeding may occur.
Lumbar puncture is contraindicated in the presence of intracranial hypertension, such as that caused by a brain mass due to the risk of having brain displacement and hernia. It should not be performed in people who have an infection in the area where the puncture will be performed, nor in people who have a brain abscess.
In addition, you should inform your doctor about the medications you are taking, especially if you are taking anticoagulants such as warfarin or clopidogrel, due to the risk of bleeding.
Samples of cerebrospinal fluid are sent to the laboratory for analysis of various parameters such as appearance, which is generally transparent and colorless. In case of presenting a yellow or pink coloration or a cloudy appearance, it may indicate infection, as well as the presence of microorganisms such as bacteria, viruses or fungi.
In addition, the total proteins and number of white blood cells are evaluated, which if they are elevated indicates infection or some inflammatory condition, the glucose if it is low can be a sign of infection or other diseases, so as the presence of abnormal cells can indicate a certain type of cancer.
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